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Salehi M, Saeedi M, Negarandeh R, Savabi A, Lotfizadeh A, Hosseinnataj A, Molania T. Evaluation of caffeic acid mucoadhesive tablets on minor recurrent aphthous stomatitis: a randomized, double-blind, placebo-controlled clinical trial. BMC Oral Health 2024; 24:210. [PMID: 38336696 PMCID: PMC10858486 DOI: 10.1186/s12903-024-03936-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Oral aphthous stomatitis is a chronic inflammatory condition. Numerous medications have been investigated to treat the symptoms of the disease. However, these days patients prefer herbal medicines due to lower side effects. Considering the anti-inflammatory, analgesic, and anti-oxidant properties of Caffeic acid and its few side effects, the aim of this study was to assess the impact of Caffeic acid on recurrent aphthous stomatitis (RAS). investigating the effect of caffeic acid mucoadhesive tablets on the size and pain intensity of the aphthous lesions. METHODS in this double-blinded clinical trial study, 47 patients who met the inclusion criteria were selected by convenient sampling method. The patients were assigned to two groups randomly; the control group (placebo recipients) and the intervention group (Caffeic acid recipients). Patients were followed up for 7 days following the intervention. The diameter of the inflammatory lesion was measured in millimeters, and the pain intensity was recorded based on the VAS scale (Visual Analogue Scale). This trial was approved by the medical ethics committee of Mazandaran University of Medical Sciences (Ethical code: IR.MAZUMS.REC.1401.261) and received IRCT code of IRCT20220815055700N1on 03/09/2022. RESULTS the diameter of the lesion in both groups decreased over time, and there was no significant difference between the intervention and control groups, except on the fifth day when the diameter of the lesion was significantly greater in the control group (P = 0.012). From the second day, the control group's average pain intensity was significantly higher than the intervention group's pain intensity (P < 0.05). CONCLUSIONS when comparing mucoadhesive tablets containing Caffeic acid and placebo, the findings demonstrated that Caffeic acid has a significant efficacy in reducing aphthous lesions' diameter and pain intensity of the patients and are suggested for palliative oral aphthous lesions treatment since they showed significant anti-inflammatory and analgesic effects on recurrent aphthous stomatitis.
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Affiliation(s)
- Maedeh Salehi
- Department of Oral Medicine, Dental Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Majid Saeedi
- Department of Pharmaceutics, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Negarandeh
- Department of Pharmaceutics, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
- Student Research Committee, Department of Pharmaceutics, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | | | | | - Abolfazl Hosseinnataj
- Department of Biostatistics, Faculty of health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Tahereh Molania
- Department of Oral Medicine, Dental Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
- Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran.
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Manginstar CO, Tallei TE, Niode NJ, Salaki CL, Hessel SS. Therapeutic potential of propolis in alleviating inflammatory response and promoting wound healing in skin burn. Phytother Res 2024; 38:856-879. [PMID: 38084816 DOI: 10.1002/ptr.8092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 10/22/2023] [Accepted: 11/28/2023] [Indexed: 02/15/2024]
Abstract
Burns can cause inflammation and delayed healing, necessitating alternative therapies due to the limitations of conventional treatments. Propolis, a natural bee-produced substance, has shown promise in facilitating burn healing. This literature review provides a comprehensive overview of propolis' mechanisms of action, wound-healing properties, and its application in treating skin burns. Propolis contains bioactive compounds with antimicrobial, antioxidant, and anti-inflammatory properties, making it a promising candidate for managing skin burn injuries. It helps prevent infections, neutralize harmful free radicals, and promote a well-balanced inflammatory response. Moreover, propolis aids in wound closure, tissue regeneration, collagen synthesis, cellular proliferation, and angiogenesis, contributing to tissue regeneration and remodeling. The article discusses various propolis extracts, extraction methods, chemical composition, and optimized formulations like ointments and creams for burn wound treatment. Considerations regarding dosage and safety are addressed. Further research is needed to fully understand propolis' mechanisms, determine optimal formulations, and establish suitable clinical dosages. Nevertheless, propolis' natural origin and demonstrated benefits make it a compelling avenue for burn care exploration, potentially complementing existing therapies and improving burn management outcomes.
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Grants
- 158/E5/PG.02.00.PL/2023 Directorate of Research, Technology, and Community Engagement at the Ministry of Education, Culture, Research, and Technology, Republic of Indonesia
- 1803/UN12.13/LT/2023 Directorate of Research, Technology, and Community Engagement at the Ministry of Education, Culture, Research, and Technology, Republic of Indonesia
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Affiliation(s)
- Christian Oktavianus Manginstar
- Entomology Study Program, Postgraduate Program, Sam Ratulangi University, Manado, Indonesia
- Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, Sam Ratulangi University, Prof. Dr. R. D. Kandou Central General Hospital, Manado, Indonesia
| | - Trina Ekawati Tallei
- Department of Biology, Faculty of Mathematics and Natural Sciences, Sam Ratulangi University, Manado, Indonesia
- Department of Biology, Faculty of Medicine, Sam Ratulangi University, Manado, Indonesia
| | - Nurdjannah Jane Niode
- Department of Dermatology and Venereology, Faculty of Medicine, Sam Ratulangi University, Prof. Dr. R. D. Kandou Central General Hospital, Manado, Indonesia
| | - Christina Leta Salaki
- Plant Protection Study Program, Faculty of Agriculture, Sam Ratulangi University, Manado, Indonesia
| | - Sofia Safitri Hessel
- Indonesia Biodiversity and Biogeography Research Institute (INABIG), Bandung, Indonesia
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Yun JH, Jang JY, Shin YS, Kim HJ, Kim CH, Park DY. Effect of monopolar diathermy power settings on postoperative pain, wound healing, and tissue damage after tonsillectomy: a randomized clinical trial. Sci Rep 2024; 14:267. [PMID: 38167450 PMCID: PMC10761731 DOI: 10.1038/s41598-023-50633-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024] Open
Abstract
This study aimed to assess the impact of varying monopolar diathermy power settings on postoperative pain, hemorrhage, and wound healing following tonsillectomy. A single-center, prospective, randomized, double-blinded, controlled clinical study was conducted. During bilateral tonsillectomy procedures, one tonsil received low-power settings (15 W, cutting/blend) while the other tonsil received high-power settings (35 W, cutting/blend). Postoperative pain scores (0-10) and wound healing scores (0-3) were evaluated immediately after surgery and at 1, 2, and 4 weeks postoperatively using the visual analog scale. Additionally, histological analysis was performed on electrically resected tonsil tissues to assess tissue damage in the tonsil bed. The allocation of high and low power settings to each side was randomized. Results showed that 1 week after the surgery, the high-power group experienced significantly higher pain scores (mean ± standard deviation: 4.84 ± 2.21) compared to the low-power group (3.56 ± 2.24, p = 0.049). Moreover, the high-power side exhibited slower wound healing during the initial 1-2 weeks postoperatively, as indicated by lower wound scores at 2 weeks (high-power: 1.96 ± 0.64; low-power: 2.43 ± 0.59, p = 0.008). Furthermore, histological analysis revealed significantly deeper tissue degradation on the high-power side compared to the low-power side (p < 0.001), with mean depths of 565.2 ± 291.0 µm and 156.0 ± 36.8 µm, respectively. In conclusion, these findings suggest that when employing monopolar diathermy in tonsillectomy, lower power settings can lead to improved outcomes in terms of postoperative pain, wound healing, and tissue damage.Trial registration: CRIS identifier: KCT0005670 (cris.nih.go.kr, registration date: 11/12/2020).
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Affiliation(s)
- Ju Hyun Yun
- Department of Otolaryngology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea
| | - Jeon Yeob Jang
- Department of Otolaryngology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea
| | - Yoo Seob Shin
- Department of Otolaryngology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea
| | - Hyun Jun Kim
- Department of Otolaryngology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea
- Sleep Center, Ajou University Hospital, Suwon, Republic of Korea
| | - Chul-Ho Kim
- Department of Otolaryngology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea
| | - Do-Yang Park
- Department of Otolaryngology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea.
- Sleep Center, Ajou University Hospital, Suwon, Republic of Korea.
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Hatfield J, Saad S, Housewright C. Dietary supplements and bleeding. Proc AMIA Symp 2022; 35:802-807. [DOI: 10.1080/08998280.2022.2121575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Affiliation(s)
- Jess Hatfield
- Texas A&M Health Science Center College of Medicine, Temple, Texas
| | - Saadeddine Saad
- Department of Dermatology, Baylor Scott and White Medical Center – Temple, Temple, Texas
| | - Chad Housewright
- Department of Dermatology, Baylor Scott and White Medical Center – Temple, Temple, Texas
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Susan S, Ravalia M, Zulhendri F. Unusual presentation of oral hemangioma in tongue and the potential use of propolis as an adjunctive treatment. Clin Case Rep 2021; 9:e05243. [PMID: 34987814 PMCID: PMC8693239 DOI: 10.1002/ccr3.5243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/29/2021] [Accepted: 12/11/2021] [Indexed: 11/12/2022] Open
Abstract
Tongue hemangioma is a rare case of vascular tumors that causes symptoms such as pain, bleeding, difficulty in chewing, speaking, and breathing. We report a case of an oral lobular capillary hemangioma on the dorsal surface of the tongue treated with surgical excision and postoperative application of propolis extract.
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Affiliation(s)
| | | | - Felix Zulhendri
- Scientific ConsultantNorth SumatraIndonesia
- Center of Excellence in Higher Education for Pharmaceutical Care InnovationUniversitas PadjadjaranJatinangorIndonesia
- Physiology DivisionDepartment of Biomedical SciencesFaculty of MedicineUniversitas PadjadjaranBandungIndonesia
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Nonwoven Releasing Propolis as a Potential New Wound Healing Method-A Review. Molecules 2021; 26:molecules26185701. [PMID: 34577172 PMCID: PMC8471897 DOI: 10.3390/molecules26185701] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/17/2021] [Accepted: 09/18/2021] [Indexed: 01/22/2023] Open
Abstract
Wound healing poses a serious therapeutic problem. Methods which accelerate tissue regeneration and minimize or eliminate complications are constantly being sought. This paper is aimed at evaluation of the potential use of biodegradable polymer nonwovens releasing propolis as wound healing dressings, based on the literature data. Propolis is honeybee product with antioxidant, antibacterial, antifungal, anticancer, anti-inflammatory, analgesic, and regenerative properties. Controlled release of this substance throughout the healing should promote healing process, reduce the risk of wound infection, and improve aesthetic effect. The use of biodegradable aliphatic polyesters and polyester carbonates as a propolis carrier eliminates the problem of local drug administration and dressing changes. Well-known degradation processes and kinetics of the active substance release allows the selection of the material composition appropriate to the therapy. The electrospinning method allows the production of nonwovens that protect the wound against mechanical damage. Moreover, this processing technique enables adjusting product properties by modifying the production parameters. It can be concluded that biodegradable polymer dressings, releasing a propolis, may find potential application in the treatment of complicated wounds, as they may increase the effectiveness of treatment, as well as improve the patient’s life quality.
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Kang Y, Ku EJ, Jung IG, Kang MH, Choi YS, Jung HJ. Dexamethasone and post-adenotonsillectomy pain in children: Double-blind, randomized controlled trial. Medicine (Baltimore) 2021; 100:e24122. [PMID: 33466183 PMCID: PMC7808470 DOI: 10.1097/md.0000000000024122] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 12/09/2020] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To assess the impact of intraoperative intravenous dexamethasone on the reduction of postoperative morbidity in children undergoing adenotonsillectomy. METHODS A double blind randomized controlled trial conducted among children undergoing adenotonsillectomy at a tertiary hospital in Korea from November 2018 to June 2019. Children were randomly assigned to receive dexamethasone (0.5 mg/kg, maximum dose 24 mg) or placebo intravenously after induction of anesthesia. The primary endpoint was the reduction of postoperative pain and postoperative nausea and vomiting (PONV); secondary endpoints were adverse effects like postoperative hemorrhage. RESULTS The study included 105 children, and 67 were male. Their mean age was 6.2 ± 2.1 years. There was no significant difference between the groups in terms of demographic data or the operation time. The pain scores of the dexamethasone group were lower than those of the control group, but no significant difference was found (all P > .05). The average pain visual analog scale (VAS) during the study period (day 0-7) was 3.67 ± 1.59 and 4.40 ± 2.01 in the dexamethasone group and control group, respectively (P-value = .107). When we compared early pain VAS (day 0-2) and late pain VAS (day 5-7), the dexamethasone group showed significantly lower early mean VAS compared to the control group (4.55 ± 1.78 vs 5.40 ± 2.05, P-value = .046). The mean VAS for PONV was significantly lower in the dexamethasone group than in the control group (1.89 ± 2.22 vs 3.00 ± 2.37, P value = .044). CONCLUSION In children undergoing adenotonsillectomy, dexamethasone decreased the early postoperative pain and PONV without increasing postoperative hemorrhage.
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Affiliation(s)
- Young Kang
- Department of Otorhinolaryngology-Head and Neck Surgery
| | - Eu Jeong Ku
- Department of Internal Medicine, Chungbuk National University College of Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Il Gu Jung
- Department of Otorhinolaryngology-Head and Neck Surgery
| | | | | | - Hahn Jin Jung
- Department of Otorhinolaryngology-Head and Neck Surgery
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Rojczyk E, Klama-Baryła A, Łabuś W, Wilemska-Kucharzewska K, Kucharzewski M. Historical and modern research on propolis and its application in wound healing and other fields of medicine and contributions by Polish studies. JOURNAL OF ETHNOPHARMACOLOGY 2020; 262:113159. [PMID: 32736052 DOI: 10.1016/j.jep.2020.113159] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/28/2020] [Accepted: 07/03/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The history of medical application of propolis (also known as bee glue) dates back to the times of ancient Greeks, Romans, Persians and Egyptians. Honey and other bee products, including propolis, occupy an important place in Polish folk medicine. Scientific research on propolis in Poland began in the early 1960s in Zabrze and continues until now. AIM OF THE REVIEW The aim of this review is to provide an overview of information on Polish research on propolis and its medical application with particular emphasis on studies concerning wound healing. Consequently, our goal is also to shed a new light on therapeutic potential of Polish propolis in order to support future research in the field. MATERIALS AND METHODS A systematic review of scientific literature on propolis and its medical application was performed by using the literature databases (PubMed, Web of Science, Google Scholar). We paid special attention to papers describing the effect of propolis on skin wound healing as well as to Polish contribution to research on propolis. RESULTS Professor Stan Scheller was the first Polish scientist dealing with propolis and its medical potential. His legacy was continued by several research teams that studied the topic in various aspects. They analyzed propolis composition, its antioxidant, anti-inflammatory, antimicrobial, antiapoptotic and anticancer properties as well as its application in dentistry and wound treatment. Burn wound healing physiology after propolis administration was thoroughly studied on pig model, whereas research on patients proved the efficacy of propolis in chronic venous leg ulcer treatment. CONCLUSION Polish scientists have made a significant contribution to the research on propolis, its biological properties and influence on wound healing. Propolis ointments can effectively accelerate the healing process and improve healing physiology, so they can be recommended as a promising topical medication for wound treatment in the future clinical and preclinical trials.
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Affiliation(s)
- Ewa Rojczyk
- Department of Descriptive and Topographic Anatomy, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 19 Jordana Street, 41-808, Zabrze, Poland.
| | - Agnieszka Klama-Baryła
- The Burn Centre of Stanisław Sakiel, 2 Jana Pawła II Street, 41-100, Siemianowice Śląskie, Poland.
| | - Wojciech Łabuś
- The Burn Centre of Stanisław Sakiel, 2 Jana Pawła II Street, 41-100, Siemianowice Śląskie, Poland.
| | - Katarzyna Wilemska-Kucharzewska
- Department of Internal Medicine, School of Public Health in Bytom, Medical University of Silesia, 7 Żeromskiego Street, 41-902, Bytom, Poland.
| | - Marek Kucharzewski
- Department of Descriptive and Topographic Anatomy, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 19 Jordana Street, 41-808, Zabrze, Poland; The Burn Centre of Stanisław Sakiel, 2 Jana Pawła II Street, 41-100, Siemianowice Śląskie, Poland.
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Faramarzi M, Shishegar M, Kazemi T, Tavakolpour Saleh H, Roosta S. The effect of applying amniotic membrane on post-tonsillectomy pain and bleeding. Eur Arch Otorhinolaryngol 2020; 278:485-492. [PMID: 32601919 DOI: 10.1007/s00405-020-06173-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 06/24/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE Pain and hemorrhage are common morbidities after tonsillectomy. Although many studies have focused on post-tonsillectomy pain, inadequate researches are available on wound healing. Hence, there is a definite need for a novel technique to facilitate the healing process and thereby improving the post-tonsillectomy recovery. METHODS This prospective and randomized study was conducted on 60 adult patients who underwent tonsillectomy. They were divided into two groups of control and amniotic membrane (AM). Human amniotic membrane was applied over the tonsillar bed as a biologic dressing. Post-tonsillectomy pain and bleeding were evaluated. Also, the healing rate was assessed on days 5, 10 and 15 post-operatively. RESULTS The pain score in the AM group was lower than that in the control group during the first week after surgery (P < 0.0001). Moreover, the AM group returned faster to their normal diet in comparison with the control group (P < 0.0001). With respect to the healing rate, there were no significant differences between the groups on day 5 (P > 0.05), whereas a significant difference was seen on days 10 and 15 post-surgery (P < 0.0001). There was no significant difference between the two groups in terms of post-operative bleeding (P ≅ 1). CONCLUSION We observed that the use of AM graft as a biologic dressing might be beneficial in reducing post-operative pain and promoting the wound healing process. The results represent a further step toward developing a new technique for coverage of tonsillar fossa with sheeting or wearing grafts.
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Affiliation(s)
- Mohammad Faramarzi
- Department of Otolaryngology Head and Neck Surgery, Otolaryngology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahmood Shishegar
- Department of Otolaryngology Head and Neck Surgery, Otolaryngology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Tayebeh Kazemi
- Department of Otolaryngology Head and Neck Surgery, Otolaryngology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Tavakolpour Saleh
- Department of Otolaryngology Head and Neck Surgery, Otolaryngology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sareh Roosta
- Department of Otolaryngology Head and Neck Surgery, Otolaryngology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Liu L, Rodman C, Worobetz NE, Johnson J, Elmaraghy C, Chiang T. Topical biomaterials to prevent post-tonsillectomy hemorrhage. J Otolaryngol Head Neck Surg 2019; 48:45. [PMID: 31492172 PMCID: PMC6731608 DOI: 10.1186/s40463-019-0368-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 08/27/2019] [Indexed: 12/11/2022] Open
Abstract
Despite advances in surgical technique, postoperative hemorrhage remains a common cause of mortality and morbidity for patients following tonsillectomy. Application of biomaterials at the time of tonsillectomy can potentially accelerate mucosal wound healing and eliminate the risk of post-tonsillectomy hemorrhage (PTH). To understand the current state and identify possible routes for the development of the ideal biomaterials to prevent PTH, topical biomaterials for eliminating the risk of PTH were reviewed. Alternative topical biomaterials that hold the potential to reduce the risk of PTH were also summarized.
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Affiliation(s)
- Lumei Liu
- Center of Regenerative Medicine, Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Cole Rodman
- College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Noah E Worobetz
- Center of Regenerative Medicine, Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.,Department of Pediatric Otorhinolaryngology, Nationwide Children's Hospital, Columbus, OH, USA
| | | | - Charles Elmaraghy
- College of Medicine, The Ohio State University, Columbus, OH, USA.,Department of Pediatric Otorhinolaryngology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Tendy Chiang
- Center of Regenerative Medicine, Research Institute at Nationwide Children's Hospital, Columbus, OH, USA. .,College of Medicine, The Ohio State University, Columbus, OH, USA. .,Department of Pediatric Otorhinolaryngology, Nationwide Children's Hospital, Columbus, OH, USA.
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Kim JH, Jang SJ, Yun JW, Jung MH, Woo SH. Effects of pepsin and pepstatin on reflux tonsil hypertrophy in vitro. PLoS One 2018; 13:e0207090. [PMID: 30408092 PMCID: PMC6224077 DOI: 10.1371/journal.pone.0207090] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 10/24/2018] [Indexed: 12/18/2022] Open
Abstract
There is evidence that pepsin can aggravate tonsil hypertrophy. Pepstatin is a potent inhibitor of pepsin activity and could protect patients against reflux tonsil hypertrophy by inhibiting pepsin. We examined the effects of pepstatin on the development of tonsil hypertrophy to investigate pepsin’s role in the pathogenesis of tonsil lesions. We investigated whether pepstatin suppresses pepsin-mediated lymphocyte proliferation in tonsil hypertrophy. Forty-nine children with tonsil hypertrophy and twenty-two adults with tonsillitis were recruited to the study prior to surgery. Tonsil tissue from each patient was harvested and assessed for changes in the number of lymphocytes and macrophages in the presence of pepsin and pepstatin. We found that the proportions of CD4- and CD14-positive cells were significantly lower (p < 0.05), but that the proportions of CD19- and CD68-positive cells were significantly higher (p < 0.05), in children than in adults. There were significantly more CD4-positive cells after pepsin treatment, but these numbers were reduced by pepstatin. The levels of both interleukin-2 (IL-2) and interferon gamma (IFN-γ) increased significantly in response to pepsin, but were reduced when pepsin was inhibited by pepstatin. The level of IL-10 is reduced in pepsin-treated CD4 cells and the level is restored by pepstatin. IL-2 blocking reduced the increased CD4 cell number by pepsin. But, an additive or a synergic effect is not founded in combined with IL-2 blocking and pepstatin. Pepsin-positive cells did not co-localize with CD20 and CD45 cells, but they were found surrounding CD20- and CD45-positive hypertrophic tonsil cells. Pepsin-positive cells co-localized with CD68-positive cells. It is probable that pepsin from extraesophageal reflux aggravates tonsil hypertrophy and pepstatin exerts a protective effect by inhibiting pepsin activity.
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Affiliation(s)
- Jin Hyun Kim
- Biomedical Research Institute, Gyeongsang National University Hospital, Jinju, Korea
- Institute of Health Science, Gyeongsang National University, Jinju, Korea
| | - Si Jung Jang
- Biomedical Research Institute, Gyeongsang National University Hospital, Jinju, Korea
| | - Jeong Won Yun
- Department of Otorhinolaryngology-Head and Neck Surgery, Gyeongsang National University Hospital, Jinju, Korea
| | - Myeong Hee Jung
- Biomedical Research Institute, Gyeongsang National University Hospital, Jinju, Korea
| | - Seung Hoon Woo
- Institute of Health Science, Gyeongsang National University, Jinju, Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Gyeongsang National University Hospital, Jinju, Korea
- Beckman Laser Institute, University of California, Irvine, California, United States of America
- * E-mail:
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12
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Akcan FA, Dündar Y. Posterior pillar mucosal suspension technique for posttonsillectomy pain and wound healing: a prospective, randomized, controlled trial. Eur Arch Otorhinolaryngol 2018; 275:2879-2887. [DOI: 10.1007/s00405-018-5148-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 09/24/2018] [Indexed: 12/15/2022]
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